Association Between Dietary Protein Intake and Sleep Quality in Middle-Aged and Older Adults in Singapore

Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices

Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.

Effectiveness of Physical Activity-Led Workplace Health Promotion Interventions: A Systematic Review

Background: With increasing work pace and stress, sedentary office habits and insufficient physical activity (PA) pose significant threats to employee health and organizational productivity. Physical activity-led workplace health interventions (PAWHIs) have gained attention due to their multifaceted benefits for employees' physical and mental health. This systematic review aims to evaluate the effectiveness of PAWHIs and examine the success rates of PA combined with various supplementary intervention approaches in improving employee health. Methods: This study was conducted according to the PRISMA 2020 statement guidelines. A systematic search was performed across four databases (PubMed, Web of Science, EBSCO, and Scopus) for randomized controlled trials (RCTs) published between 2013 and 2023. The Cochrane risk-of-bias tool was used to assess the risk of bias in the included studies. Results: After screening, 40 studies meeting the criteria were finally identified and subjected to quality assessment. The primary intervention measures of PAWHIs focused on education, physical activity, and dietary interventions. Fifty percent of the studies adopted multimodal combined intervention schemes involving two or more types of interventions. The most common intervention durations were 12 weeks (9 studies) and 24 weeks (24 studies). An analysis of the various intervention effects of PAWHIs revealed that the most successfully improved outcomes were increased physical activity levels (26/32), reduced psychological stress (4/5), and improved dietary habits (12/19), with over 60% of the related studies reporting positive effects. Additionally, improvements were also commonly observed in body composition (16/29) and clinical health outcomes (15/27). Conclusions: PAWHIs have positive effects on improving employee health status and promoting healthy behaviors, particularly in increasing PA levels and reducing psychological stress. However, interventions need to be contextualized and further optimized to achieve more comprehensive and sustainable health outcomes.

Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study

Background

The current study aimed to evaluate the association between the intake of plant-based protein, animal-based protein, total protein, and the ratio of plant to animal protein with sleep quality and quality of life in patients undergoing hemodialysis.

Methods

In this cross-sectional study, 479 adult patients undergoing dialysis for a minimum of 3 months were included. The dietary intake was calculated using information from a validated 168-item semi-quantitative food frequency questionnaire. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3). and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.

Results

In this study, the mean age of the participants was 58.18 years (± 14.25 years), with the majority being male (58.2%). After adjusting for potential confounders, significant positive associations were observed between total protein intake (β = 0.12, p = 0.03) and quality of life (QOL). Conversely, there were significant negative associations between the ratio of plant to animal protein intake (β = -0.94, p < 0.01) and QOL. Furthermore, significant negative associations were found between total protein intake (β = -0.02, p < 0.05) and animal protein intake (β = -0.19, p < 0.05) with poor sleep quality. Additionally, there were significant positive associations between the ratio of plant to animal protein intake (β = 0.188, p < 0.05) and poor sleep quality.

Conclusion

Increased consumption of animal protein is associated with improved sleep quality and Quality of Life (QOL) in patients undergoing hemodialysis (HD). Further research, especially prospective studies, is required to confirm these associations.

Associations of Advanced Glycation End Products with Sleep Disorders in Chinese Adults

BACKGROUND

Advanced glycation end products (AGEs), a group of food processing byproducts, have been implicated in the development of various diseases. However, the relationship between circulating AGEs and sleep disorders remains uncertain.

METHODS

This cross-sectional study elucidated the association of plasma AGEs with sleep disorders among 1732 Chinese adults who participated in the initial visit (2019-2020) of the Tongji-Shenzhen Cohort (TJSZC). Sleep behavior was assessed using self-reported questionnaires and precise accelerometers. Plasma levels of AGEs, including Nε-(Carboxymethyl)lysine (CML), Nε-(Carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine (MG-H1), were quantified by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

RESULTS

In logistic regression, per IQR increment in individual AGEs was associated with an increased odds ratio of short sleep duration (CML: 1.11 [1.00, 1.23]; CEL: 1.16, [1.04, 1.30]), poor sleep quality (CML: 1.33 [1.10, 1.60]; CEL: 1.53, [1.17, 2.00]; MG-H1: 1.61 [1.25, 2.07]), excessive daytime sleepiness (CML: 1.33 [1.11, 1.60]; MG-H1: 1.39 [1.09, 1.77]), and insomnia (CML: 1.29 [1.05, 1.59]). Furthermore, in weighted quantile sum regression and Bayesian kernel machine regression analyses, elevated overall exposure levels of plasma AGEs were associated with an increased risk of sleep disorders, including short sleep duration, poor sleep quality, excessive daytime sleepiness, and insomnia, with CML being identified as the leading contributor. Insufficient vegetable intake and higher dietary fat intake was associated with an increase in plasma CEL.

CONCLUSIONS

These findings support a significant association between plasma AGEs and sleep disorders, indicating that AGEs may adversely influence sleep health and reducing the intake of AGEs may facilitate preventing and ameliorating sleep disorders.

The association of dietary inflammatory index with sleep outcomes: A systematic review

Background

Sleep is a vital physiological process that plays a crucial role in various aspects of human health and well-being. Regarding the important role of diet on the sleep quality, the present study aimed to assess the association of dietary inflammatory index (DII) with the sleep outcomes and also to provide the potential mechanisms of action.

Methods

PubMed, Web of Science and Scopus databases and Google Scholar search engine were systematically searched for relevant studies related to DII and sleep outcomes using appropriate search terms until February 2024.

Results

From the initial systematic search of databases, 197 studies were retrieved. However, only 14 of them met the criteria for evaluation. Out of these, eleven studies indicated a significant correlation between higher DII scores and poor overall sleep quality and/or short/long sleep duration or its subscales. On the contrary, four studies did not find any proof of this association.

Conclusion

This systematic review indicated that following an anti-inflammatory diet could potentially lead to an improvement in the sleep outcomes. Well-designed clinical trials in the future will be necessary to provide a better understanding and quantification of this association.

Protein intake and its association with sleep quality: results from 3 prospective cohort studies

BACKGROUND/OBJECTIVES

Sleep quality is a critical factor for daytime functioning and chronic disease risk. We investigated the association between intakes of total protein and protein subtypes and sleep quality in three U.S. cohorts.

SUBJECTS/METHODS

In the Nurses' Health Study (NHS), NHS2, and Health Professionals Follow-up study (HPFS), dietary intake was assessed every 4 years using validated food frequency questionnaires. Sleep quality was measured once with the Pittsburgh Sleep Quality Index or adapted versions. With ordinal logistic regression, odds ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the odds of having better sleep quality versus poorer sleep quality depending on protein intake (%Energy) based on the average of the prior two dietary questionnaires.

RESULTS

In 32,212 women from NHS, 51,126 women from NHS2, and 14,796 men from HPFS, total protein intake was not associated with sleep quality. However, the intake of protein from vegetable sources showed no association or a positive association with sleep quality (OR for quartile 4 versus quartile 1 in NHS: 1.12, 1.04-1.20, P-trend < 0.001; NHS2: 1.01, 0.95-1.07, P-trend = 0.90; HPFS: 1.11, 0.99-1.23, P-trend = 0.05), whereas divergent results were observed for animal protein sources. Overall, intakes of processed red meat and poultry were associated with worse sleep quality, whereas no or positive associations were observed for dairy and fish protein.

CONCLUSION

Our results suggest that plants as a source of protein may be associated with better sleep quality than animal sources of protein. Further studies are warranted to validate our findings.

Sweet dreams are not made of this: no association between diet and sleep quality

STUDY OBJECTIVES

Numerous studies have emphasized the significance of nutrition on the quality of sleep, but few have evaluated the effect of various coexisting dietary markers on middle-aged adults. We assessed the association between sleep quality and a large array of dietary markers among middle-aged, community-dwelling participants.

METHODS

Data from the first, second, and third follow-ups of CoLaus|PsyCoLaus, a population-based study in Lausanne, Switzerland, was used. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. Dietary intake was assessed by a validated food frequency questionnaire.

RESULTS

Data from 3857 (53% women, 57.2 ± 10.4 years), 2370 (52% women, 60.7 ± 9.5 years), and 1617 (52% women, 63.5 ± 9.0 years) participants from the first, second, and third follow-ups was used. Bivariate correlations showed fish, vegetables, fruit, and cheese intake to be associated with a better sleep quality (lower Pittsburgh Sleep Quality Index), while rusks, sugar, and meat intake were associated with a poorer sleep quality (higher Pittsburgh Sleep Quality Index). After multivariable adjustment, participants reporting poor sleep quality (Pittsburgh Sleep Quality Index > 5) had a lower Mediterranean diet score and a lower likelihood of complying with the meat and fish recommendations, but the results were inconsistent between surveys. No association was found between sleep quality and macro- or micronutrients in the three surveys.

CONCLUSIONS

No consistent associations were found between a large panel of nutritional markers and sleep quality. Components of the Mediterranean diet such as dairy, fruits, and vegetables might favor good sleep quality, while increased consumption of sugary foods or meat might favor poor sleep quality.

CITATION

Oliveira JL, Marques-Vidal P. Sweet dreams are not made of this: no association between diet and sleep quality. J Clin Sleep Med. 2023;19(12):2005-2014.

The effects of low calorie, high protein diet on body composition, duration and sleep quality on obese adults: A randomized clinical trial

Background and Aims

The effects of high-protein diets on regulating sleep have received research attention in recent decades. However, no studies have examined the effects of these diets in obese adults. Therefore, this study was conducted to investigate the effects of low-calorie high protein diets on sleep quality in obese adults.

Methods

This study is a randomized clinical trial conducted on 60 obese adults (BMI > 29.9 kg/m2) diagnosed with low-quality sleep. All participants were given a diet with a 750-calorie energy deficit. While the control group was given a normal diet, the intervention group received a diet with 30% more protein.

Results

The results showed a significant difference between the control group and intervention group with respect to sleep apnea at 30-, 60-, and 90-day follow-up (p < 0.01). Sleep quality, apnea-hypopnea index (AHI), sleep latency (SL), and polysomnography were significantly different between the two groups (p < 0.05), showing an improvement in sleep quality and obstructive sleep apnea in the intervention group (p < 0.05).

Conclusion

This study shows that low-calorie high-protein diets can effectively improve apnea, sleep quality, and body composition indices in obese adults.

Enhancing Skin Anti-Aging through Healthy Lifestyle Factors

Lifestyle health has been recognized as an evidence-based innovation that defines how everyday behaviors and routines influence the avoidance and therapy of illness and provides an important adjunctive component to overall health. Specifically, an approach with small changes over time can have a dramatic impact on the health and well-being of individuals not only, in general, but also can be applied to skin health. However, lifestyle health factors to improve skin well-being have not been discussed extensively and/or well promulgated. The narrative for this overview focuses on providing a summary for topic background information, but more importantly, presents four lifestyle factors that can improve dermal health [i.e., factor 1: nutrition—diet; factor 2: rest (sleep); factor 3: movement/physical exercise, and factor 4: social and community associations]. This was accomplished by identifying preceding journal reports/reviews covering especially the last five years (January 2018 to July 2023; 164 out of 205 references cited or 80%) using scientific search databases. The main conclusions of this overview encourage the concept that lifestyle health factors such as nutrition/diet, rest/sleep, movement/physical exercise, and community/social interactions support enhanced skin health and well-being with aging. Plus, social media interventions that aim to promote dietary, sleep and physical activity changes might be an application to improve skin health in the future.

The Role of Meeting Exercise and Nutrition Guidelines on Sleep during Pregnancy

Sleep disturbances are common during pregnancy. This study determined whether meeting physical activity or dietary guidelines during pregnancy was associated with improved sleep. Third trimester pregnant women (n = 49, 31.9 ± 4.1 years) completed physical activity and sleep questionnaires and then wore a wrist actigraph 24 h/day and completed three 24 h dietary recalls across two weeks. Participants who reported meeting physical activity guidelines (>150 min moderate-to-vigorous physical activity [MVPA]/week, n = 23) or dietary guidelines (≥1.1 g protein/kg body weight/day, n = 26 or ≥25 g fiber/day, n = 16) were compared to those who were physically inactive (<90 min/week) or did not meet dietary guidelines, respectively. Multivariate ANOVAs and Mann-Whitney U tests compared groups and correlations were conducted between physical activity, diet, and sleep variables. Physical activity groups did not differ in objective sleep measures (ps > 0.05); however, the active group reported better sleep quality (p = 0.049). Those who met protein guidelines exhibited longer sleep duration and less wake-after-sleep-onset (ps < 0.05). Across all participants, higher weekly MET mins/week of MVPA associated with better sleep quality (p = 0.02), and a diet higher in fat and lower in carbohydrates associated with longer sleep duration (ps < 0.05). Meeting physical activity and nutrition guidelines positively associates with improved sleep, with protein associated with objective measures and physical activity with subjective measures.

The interplay between macronutrients and sleep: focus on circadian and homeostatic processes

Sleep disturbances are an emerging risk factor for metabolic diseases, for which the burden is particularly worrying worldwide. The importance of sleep for metabolic health is being increasingly recognized, and not only the amount of sleep plays an important role, but also its quality. In this review, we studied the evidence in the literature on macronutrients and their influence on sleep, focusing on the mechanisms that may lay behind this interaction. In particular, we focused on the effects of macronutrients on circadian and homeostatic processes of sleep in preclinical models, and reviewed the evidence of clinical studies in humans. Given the importance of sleep for health, and the role of circadian biology in healthy sleep, it is important to understand how macronutrients regulate circadian clocks and sleep homeostasis.

Sleep Quality: A Narrative Review on Nutrition, Stimulants, and Physical Activity as Important Factors

Sleep is a cyclically occurring, transient, and functional state that is controlled primarily by neurobiological processes. Sleep disorders and insomnia are increasingly being diagnosed at all ages. These are risk factors for depression, mental disorders, coronary heart disease, metabolic syndrome, and/or high blood pressure. A number of factors can negatively affect sleep quality, including the use of stimulants, stress, anxiety, and the use of electronic devices before sleep. A growing body of evidence suggests that nutrition, physical activity, and sleep hygiene can significantly affect the quality of sleep. The aim of this review was to discuss the factors that can affect sleep quality, such as nutrition, stimulants, and physical activity.